Sentences with phrase «half multiparous»

: «1.1.1 Explain to both multiparous and nulliparous women who are at low risk of complications that giving birth is generally very safe for both the woman and her baby.

1.1.2 Explain to both multiparous and nulliparous women that they may choose any birth setting (home, freestanding midwifery unit, alongside midwifery unit or obstetric unit), and support them in their choice of setting wherever they choose to give birth: Advise low ‑ risk multiparous women that planning to give birth at home or in a midwifery ‑ led unit (freestanding or alongside) is particularly suitable for them because the rate of interventions is lower and the outcome for the baby is no different compared with an obstetric unit.

Homebirth is recognised as safe for low risk women, particularly if it is not the first time they are giving birth (i.e. slightly higher risk for primiparous women than multiparous) as per «Birth Place Study» — British Medical Journal 2011 — amongst other studies.

Our results support a policy of offering healthy nulliparous and multiparous women with low risk pregnancies a choice of birth setting.

Women planning birth in a midwifery unit and multiparous women planning birth at home experience fewer interventions than those planning birth in an obstetric unit with no impact on perinatal outcomes.

For multiparous women there was no evidence of a difference in the primary outcome by planned place of birth.

For healthy multiparous women with a low risk pregnancy, there are no differences in adverse perinatal outcomes between planned births at home or in a midwifery unit compared with planned births in an obstetric unit

For multiparous women, there were no significant differences in the primary outcome between birth settings.

Transfers from non-obstetric unit settings were more frequent for nulliparous women (36 % to 45 %) than for multiparous women (9 % to 13 %).

For the three non-obstetric unit settings, transfer rates were much higher for nulliparous women (36 % to 45 %) than for multiparous women (9 % to 13 %)(table 2 ⇓).

Transfers were four times as common among primiparous women (25.1 %) as among multiparous women (6.3 %), but urgent transfers were only twice as common among primparous women (5.1 %) as among multiparous women (2.6 %).

However, higher rates of a composite outcome of perinatal morbidity and mortality were seen for nulliparous women having homebirths (adjusted odds ratio 1.75; 95 % CI, 1.07 — 2.86), with no differences for multiparous women.

The caesarean rate for intended home births was 8.3 % among primiparous women and 1.6 % among multiparous women.

An additional analysis separating multiparous and primiparous women was undertaken as well as an analysis of stillbirth and early neonatal death.

The odds of cesarean section among women planning out - of - hospital birth were lower among multiparous women than among nulliparous women and among women with 12 years of education or less than among women with more than 12 years of education (Figure 1).

We used multivariable logistic - regression models to adjust for potential confounders, including maternal race or ethnic group (non-Hispanic white vs. other), parity (nulliparous vs. multiparous), insurance status (public or none vs. other), extent of prenatal care (≥ 5 visits vs. < 5 visits), advanced maternal age (≥ 35 years vs. < 35 years), maternal education (> 12 years vs. ≤ 12 years), history or no history of cesarean delivery, and a composite marker of conditions that confer increased medical risk.

D. Krehbiel et al., «Peridural Anesthesia Disturbs Maternal Behavior in Primiparous and Multiparous Parturient Ewes,» Physiol Behav 40, no. 4 (1987): 463 — 472.

Overall, and for multiparous women, planned birth at home generated the greatest mean net benefit with a 100 % probability of being the optimal setting across all thresholds of cost effectiveness when perinatal outcomes were considered.

This decision uncertainty surrounding the most cost effective option was not found for place of birth in multiparous low risk women without complicating conditions, in whom planned home birth had a 100 % probability of being the most cost effective option across all thresholds of cost effectiveness (table 4).

With regards to maternal outcomes in nulliparous and multiparous women, planned birth at home generated the greatest mean net benefit with a 100 % probability of being the optimal setting across all thresholds of cost effectiveness.

This decision uncertainty surrounding the most cost effective option was not found for place of birth in multiparous low risk women, on whom planned home birth had a 100 % probability of being the most cost effective option across all cost effectiveness thresholds between # 0 and # 100000 (table 3).

No difference in long - term outcomes for planned home versus planned hospital births for multiparous women.

Given the available literature, before diagnosing arrest of labor in the second stage and if the maternal and fetal conditions permit, at least 2 hours of pushing in multiparous women and at least 3 hours of pushing in nulliparous women should be allowed (Table 3).

For example, the recent Eunice Kennedy Shriver National Institute of Child Health and Human Development document suggested allowing one additional hour in the setting of an epidural, thus, at least 3 hours in multiparous women and 4 hours in nulliparous women be used to diagnose second - stage arrest, although that document did not clarify between pushing time or total second stage (33).

The duration of the second stage of labor and its relationship to neonatal outcomes has been less extensively studied in multiparous women.

In this study, the 95th percentile rate of active phase dilation was substantially slower than the standard rate derived from Friedman's work, varying from 0.5 cm / h to 0.7 cm / h for nulliparous women and from 0.5 cm / h to 1.3 cm / h for multiparous women (the ranges reflect that at more advanced dilation, labor proceeded more quickly)(Table 2).

A prospective study of the progress of labor in 220 nulliparous women and 99 multiparous women who spontaneously entered labor evaluated the benefit of prolonging oxytocin augmentation for an additional 4 hours (for a total of 8 hours) in patients who were dilated at least 3 cm and had unsatisfactory progress (either protraction or arrest) after an initial 4 - hour augmentation period (21).

The vaginal delivery rate for women who had not progressed despite 2 hours of oxytocin augmentation was 91 % for multiparous women and 74 % for nulliparous women.

Researchers have found that after a 3 - hour or more second stage of labor, only one in four nulliparous women (27) and one in three multiparous women give birth spontaneously, whereas up to 30 — 50 % may require operative delivery to give birth vaginally in the current second stage of labor threshold environment (30).

On the basis of the 95th percentile threshold, historically, the latent phase has been defined as prolonged when it exceeds 20 hours in nulliparous women and 14 hours in multiparous women (18).

A population - based study of 58,113 multiparous women yielded similar results when the duration of the second stage was greater than 2 hours (31).

Case mothers were more likely to be young (< 25 years), unmarried, and multiparous and were less likely to have completed high school compared with control mothers.

Rates of cesarean section for multiparous women, when women with previous cesarean sections were excluded, were not different (p value cut - off for statistical significance after the Bonferroni correction 0.002).

Mothers will be middle class with no psychiatric problems, half primiparous, half multiparous.

Using this tool we compared the outcomes of planned home births with those of planned hospital births for primiparous and multiparous women after controlling for the confounding effects of social, medical, and obstetric background.

However, the multiparous women in our study were at low risk and their history would not have prompted referral to an obstetrician.

Power analysis, based on detecting a significant difference in the combined frequency of non-optimal factors during and after childbirth, led us to aim for a sample size of 1600 women, with approximately half being multiparous and preferably half choosing hospital birth.

Primiparous women (t = 1.99, P < 0.05) and multiparous women (t = 5.56, P < 0.001) with a planned home birth scored better on the perinatal outcome index than those with planned hospital birth.

A closer look at the background characteristics shows that multiparous women with a complicated previous pregnancy, including instrumental delivery in our study, were more likely to opt for hospital birth than for home birth.

These risks may differ among different women (for instance, nulliparous vs. multiparous), and women should understand what the risks are so that they can make informed decisions about their personal circumstances.

Primiparous women and multiparous women were considered separately because of well known differences in outcome.

In multiparous women, perinatal outcome was significantly better for planned home births than for planned hospital births, with or without control for background variables.

Multiparous women were more likely to choose a hospital birth if they belonged to an ethnic minority; had a non-optimal body mass (Quetelet index outside the range 18.8 - 24.2; P < 0.05); had a history of obstetric complications, preterm birth, or instrumental delivery; or had received medication (including vitamins and iron) in pregnancy (table 2).

Percentage non-optimal characteristics in the perinatal background index among planned home and planned hospital births in primiparous and multiparous women

For multiparous women, the most common indication was fetal malpresentation (25.8 %), followed by nonreassuring FHR tracing (24.6 %) and failure to progress (19.5 %).

57 % Hispanic, 36 % African - American, 62 % multiparous (70 % of these had previous breastfeeding experience), mean age 25 years (SD 6.23), 51.5 % married or living with a partner, 57 % receiving Medicaid

Primiparous women were more likely to be younger, thinner, and have private health insurance than multiparous women; they also were more likely to be non-Hispanic white.

Among multiparous participants, 27/29 (93 %) in the intervention group had previously breastfed, compared with 17/25 (68 %) in the control group.

Of women in our study with prolonged second stage diagnosed, 20.5 % were delivered in less than 3 hours (for primiparous women) and in less than 2 hours (for multiparous women) from the time of complete dilation.

Primiparous women were more likely to have hypertension and to be undergoing labor induction, whereas multiparous women were more likely to have diabetes mellitus, to have a multiple gestation, and to deliver preterm.